Israel pioneering fertility treatments, ­but not legally

Israel performs highest ratio of fertility treatments in the West, but their medical aspects go unlegislated.

Israel performs the highest ratio of fertility treatments in the West, but they are carried out under regulations and directives, and their medical aspects go unlegislated according to a report Knesset members will receive Tuesday.

"Technological innovations have effected a biosocial revolution in the past 30 years," says the report, compiled by Dr. Robi Nathanson, chairman of the Macro Center for Political Economics, together with Dr. Carmel Shalev from the International Center for Health, Law and Ethics at Haifa University.

"Israel is seen as a pioneer in the fertility field," the report says. However, the state has no central data bank on fertility treatments and in the absence of legislation, decisions regarding these treatments are made by individual committees addressing individual problems.

"The Knesset ought to address the basic problem of fertility technology, hold an open, public debate on the issue and anchor the matter by appropriate legislation," states the report.

The only rules governing artificial insemination treatments, for example, come from Health Ministry guidelines, while in vitro fertilization is regulated only by the health minister's directives. Similarly, choosing a baby's gender is addressed only by an administrative ministry directive.

The only fertility matters anchored in law are surrogate pregnancy and the ban on cloning for human reproduction. A bill regulating egg donation is awaiting approval by the deputy health minister.

The report decries the absence of a central fertility data bank or registration. As a result there is no information of fertility treatments and the need for them nationwide and no assessment of the safety and effectiveness of fertility technology, its success rates and financial costs.

For example, during a Knesset debate on a proposal to regulate egg donations in 2000, health officials said 2,000 Israeli women need egg donations annually. Four years later officials said 6,000 women need the treatment, while recently they said 3,000 women undergo egg donation treatments annually, while another 6,000 are waiting in line.

Haaretz recently reported that Deputy Health Minister Yaakov Litzman intends to close down in vitro fertilization clinics with low success rates and transfer their work to hospitals, mainly in the Galilee. Litzman, having received the results of fertilization treatments at various clinics here, said he would hold a hearing for directors whose clinics have a low success rate.

"There's an incomprehensible gap between the number of fertility clinics in the center and the periphery," says Ofra Balaban, chair of the CHEN Patient Fertility association. "In the center all hospitals have fertility clinics while in the Upper Galilee women have to travel all the way to the hospital in Tiberias 10 times in the treatment month, before egg harvesting, and it's a heavy burden on everyday life."

Balaban says the association has received complaints of a shortage in medicine for fertility treatments in the north.

An international study conducted by Canada's McMaster University in 2002 ranks Israel first in the rate of fertility treatment cycles. While the 48 Western countries included in the study administered on average 289 fertility treatment cycles per 1 million residents, Israel held 1,657 annual treatment cycles. Iceland, which came second, had an average of 899 treatment cycles per million residents.

During 2007 26,679 treatment cycles were registered in Israel, a 48 percent increase since 2000, according to Health Ministry figures. Some 17 percent of the treatments - 4,585 - resulted in births. Altogether 3.7 percent of the deliveries in Israel in 2007 resulted from fertilization treatments.

The Health Ministry commented that it was forming "a professional public committee to examine the existing legislation and propose comprehensive legislation for the fertility and procreation field. The committee will take into consideration new medical technologies and social aspects."